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Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
Vancouver's Four Pillars Drug Policy
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Vancouver's Four Pillars Drug Policy

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  • 1. Four Pillars Drug Policy Program
  • 2. Introduction
    • Vancouver:
      • Port of entry for Asian opium since 1800s
      • Later, heroin and Colombian cocaine
      • Downtown eastside a regional drug market for alcohol and other drugs
      • Methamphetamine
      • Large cannabis crop in BC
      • Well established and flourishing organized crime
  • 3. Crisis of ‘80s and ‘90s
    • Dramatic increase in high quality, low cost heroin and cocaine
    • Became known as the site of the highest rate of HIV infection in the western world among IV drug users
    • Highest drug overdose death rate in Canada
    • Open drug scene
    • Downtown eastside in crisis
  • 4. The Downtown Eastside
    • 16,000 residents
    • Historic centre of Vancouver
    • Poorest urban postal code in Canada
    • Chinatown, Gastown heritage districts
    • 5,000 residential hotel rooms – in poor condition
    • Concentration of social problems over a period of 20-30 years
  • 5. Crisis of ‘80s and ‘90s
    • 1988 - 17 illicit drug OD deaths
    • 1993 - 200 illicit drug OD deaths
    • 1993 - 2001: 150 annual average in OD deaths
    • Illicit drug overdose becomes leading cause of death for men 30-45
    • Other municipalities experiencing a similar phenomena throughout BC
  • 6. Vancouver Illicit Drug Deaths 1996-2008 Office of the Chief Coroner of BC
  • 7. Responding to a continuing problem
    • 1994: Chief Coroner Task Force into overdose deaths in BC
    • 1995 – Back Alley Injection room opened by drug users
    • 1996: HIV epidemic among injection drug users
    • 1997: Health Region declares a public health emergency in the Downtown Eastside of Vancouver
    • 1997 - Provincial Health Officer report – Pay Now or Pay Later
    • 1997 – Vancouver Area Network of Drug Users formed
    • 1998 – close to 200 overdose deaths in Vancouver
    • 1998 – Out of Harms Way – community conference
  • 8. Responding cont’d
    • 1998 – Mayor’s conference on drug policy
    • 1999 – Keeping the Door Open and Harm Reduction Action Society
    • 2000 - Four Pillars Drug Strategy developed
    • 2000 – Vancouver Agreement signed
    • 2000 – From Grief to Action comes out
    • 2002 – Dr. Peter Centre opens injection room
    • 2003 – In the spring – 327 Carrall Street opens
    • 2003 – September, Insite opens
  • 9.  
  • 10.  
  • 11. Thresholds of Access to Healthcare System 2 Street Drug Scene Abstinence High Threshold Services Medium Threshold Services Contact with only 20% of active users
  • 12. Increased Access to Healthcare System Abstinence 3 Street Drug Scene 50% 15% Increase in Public Health Increase in Public Order Heroin Prescription Medium Threshold Services High Threshold Services Low Threshold Methadone Services In Prison Needle Exchange Drop In Day Centres Safe Injection Sites Work Programs Youth Programs Outreach Mental Health Services Supportive Housing
  • 13.  
  • 14. 6 The Box
  • 15. Public Health
  • 16.  
  • 17.  
  • 18. Insite – A brief history since it opened
    • Outcomes
    • Research has been overwhelmingly positive
    • Researchers have used publications in peer reviewed journals as the means with which to disseminate the findings
    • No negative impacts
    • Threats
    • No diffusion of the intervention to other localities
    • No “scaling up” to meet the need for supervised injection
    • Federal government has refused to issue exemption from Controlled Drugs and Substances Act for Insite to continue to provide service
    • The battle continues in court

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